Adenoids - what is it where they are? Causes of inflammation, symptoms, diagnosis and treatment
Adenoid vegetations, or hypertrophied (enlarged) adenoids, are an enlarged nasopharyngeal tonsil that causes breathing difficulties, hearing problems, and other disorders. This amygdala is well developed in childhood, and gradually atrophies with age, therefore, in adults, such problems are extremely rare. Most often, inflamed adenoids are found in children aged five to ten years.
Nasopharyngeal tonsil functions
Tonsils (including the nasopharyngeal or pharyngeal) are part of the human immune system, so their main function is to protect the body from viruses and bacteria that penetrate from the outside. These neoplasms are located near the respiratory tract in order to quickly stand up for protection and immediately respond to the penetration of pathogens.When an infection of the amygdala increases in size, actively producing immune cells. As soon as the inflammatory process goes away, the adenoids return to their original size.
Thus, the main function of the tonsils is to produce lymphocytes and immune cells, as well as the formation of a protective barrier from penetration of the pathogenic microorganisms into the respiratory organs. In the event that the child is often more acute respiratory viral infection and flu, the tonsils are constantly inflamed. This leads to the growth of adenoid vegetations. Subsequently, they overlap the nasopharynx, making the process of nose breathing difficult or completely impossible.
Enlarged adenoids: what is this pathology?
Adenoids are the formation that forms the basis of the nasopharyngeal tonsil. As mentioned above, for any inflammation, they increase in size, and at the end of the infectious process they return to normal. If the breaks between diseases are insignificant or the disease is delayed, then the lymphoid tissue begins to grow excessively and not quite evenly.
Hypertrophy (increase, growth) of the adenoids is a pathology that is characteristic of children from one to fifteen years old.Physicians most often diagnose hypertrophied adenoids in younger schoolchildren (5–9 years old), but recently there has been a tendency for the patients to decline in age. Thus, the number of children with this diagnosis is growing at the age of two years or even up to a year.
With the onset of puberty, the tonsils begin to atrophy, in adults, the disease occurs in very rare cases. In babies, tissue proliferation is caused by the period of formation of the body’s immune defenses and the processes of adaptation of protective systems to bacteria, viruses, fungi and various allergens, and the immaturity of the immune system. Closer to adolescence, the immune system takes over the main functions of protecting the body against pathogenic microorganisms.
Adenoids hypertrophy code in ICD-10 - J35.2. If we are talking about hypertrophy of both the adenoids and the tonsils, then this is J35.3. Other diseases of the adenoids and tonsils in the chronic course are indicated by the code J35.8. The ICD-10 is the international classification of diseases of January 2007, which is used by doctors around the world for coding diagnoses. The classification is developed by WHO.
Causes of hypertrophy of the adenoids in children
What are the main causes of adenoids (tissue proliferation)? Pathology may be due to:
- The weakness of the general immunity of the child, the degree of resistance to pathogens. This is the most important factor that affects the risk of hypertrophy. To provoke a disease can immunodeficiency of any severity.
- The nature of the food. Lymphoid tissues (including adenoids), in contact with the pathogen, as the child grows, experience much more stress if the baby was on artificial nutrition. Natural breastfeeding forms a strong immune system. In addition, the growth of adenoids is influenced by the low balance of the diet when translating to solid food, a large number of preservatives, sweets, convenience foods.
- The presence of a history of chronic inflammatory processes, especially those that are localized in the region of the oral cavity and nasopharynx. Caries, stomatitis, pharyngitis, tonsillitis and other diseases provoke the adenoids to work continuously, as a result of which they are in an enlarged state for a long time.
- Allergic reactions of the body.Any adverse reaction also causes the immune system to work for wear.
- Children's inflammatory infections. Diphtheria, measles or whooping cough can be a provoking factor, a cause of secondary inflammatory processes and lead to an increase in tonsils.
- Living in an unfavorable, from an environmental point of view, area. Pollution of air, being in dusty rooms, inhalation of vapors of various chemicals from plants cause the reaction of adenoids to stimuli and a constant inflammatory process.
- Hereditary predisposition. In some cases, the cause of hypertrophy lies in heredity, which contributes to the occurrence of lymphatism or lymphatic diathesis. It can also lead to thyroid dysfunction, manifested by a tendency to edema, general lethargy, an apathetic condition, increased body weight in relation to the norms corresponding to a certain age.
With constant attacks on the body from the external environment, given the immaturity of the immune system, the nasopharyngeal tonsil increases in size, as a result of which the mucus in the nose begins to stagnate and the breathing process is disturbed.Here it is necessary to add also the constant infections penetrating from the outside. As a result, the adenoids themselves become a hotbed of the inflammatory process.
The degree of hypertrophy of the tonsil tissue
After X-ray examination, the degree of growth of adenoid vegetation is diagnosed. The picture helps to assess the size of tumors, the stage of the spread of the inflammatory process and predict the effectiveness of conservative therapy. In modern medical practice, there are three degrees of tonsil hypertrophy, which differ in symptoms, the risk of complications and the approach to treatment.
Hypertrophied adenoids 1 degree in a child is the initial stage of the pathological process of hypertrophy. Neoplasms occupy a third of the reverse nasal passage. During the day, the child manages to breathe calmly, but when night falls, the process becomes difficult. This is due to the fact that the size of the adenoids increases when in a horizontal state. Doctors allocate a mixed degree - this is when almost half of the nasal passage is closed, less than two thirds is blocked.
In the future (2-3 degree) adenoids grow even more and require complexapproach to therapy. In the second stage, they cover two thirds of the nasal passage. The child can no longer breathe through the nose. In the third degree, the adenoids block the course completely or almost completely. This stage of the disease should be distinguished from an excess of mucus in the nose. So, if a child periodically breathes through his nose, most likely, these are not adenoids, but an accumulation of secretions.
In some cases, the fourth stage of adenoid hypertrophy is also distinguished. In this case, the nasopharynx is blocked completely or almost completely (as in the third degree). The clinical picture of the third and fourth stages is very similar, therefore differentiation has no diagnostic value. The symptoms corresponding to the last two stages of adenoid proliferation are very similar.
Enlarged adenoids always make themselves felt to a greater or lesser extent. The first manifestations of the disease are usually not very pronounced. Many parents tend to confuse them with seasonal exacerbation of ARVI. Pathology progresses gradually. In the second stage, enlarged adenoids make the voice distorted. In addition, the pathology is characterized by difficulty breathing through the nose, frequent cough, sleep disorders.Usually, these changes are not even noted by parents who are constantly with the child, but relatives (against the background of rare meetings) or an ENT doctor (during a routine examination or treatment for frequent illnesses).
How to determine adenoid hypertrophy? Symptoms include the following:
- breathing through the mouth, the child cannot breathe through the nose at all or it is difficult for him;
- trouble swallowing food and smelling;
- change the sound of the voice;
- hearing problems (ENT organs are associated);
- snoring, frequent waking in the middle of the night, insomnia;
- chronic rhinitis and frequent otitis;
- the child starts to talk quietly;
- babies have difficulties with the process of sucking, the crumb gains weight poorly;
- the child complains of a foreign body sensation in the throat;
- headaches, especially in the morning;
- overweight (a sign of hereditary predisposition to hypertrophy of the tonsils, this may accompany the inflammatory process itself).
In a chronic disease (except for the main symptoms), the nasal septum is bent, the child is distinguished by slightly bulging eyes, the jaw protruding forward, other characteristic signs may appear.Adenoids continue to grow with the disease, and because of prolonged breathing through the mouth, the child may have a half-open mouth and an overbite (the incisors come forward).
Adenoiditis (inflammatory process) is accompanied by the following symptoms:
- constant nasal congestion;
- change of voice timbre;
- sore throat and cough;
- temperature increase;
- mouth breathing;
- violation of diet, appetite.
Runny nose with adenoiditis is not eliminated with the help of vasoconstrictor drops.
Adenoid vegetation and adenoiditis
Adenoid vegetation (enlarged adenoids) is not the same as adenoiditis. Here we are talking about two different diseases. Enlarged adenoids, as mentioned above, call the growth of the tonsil in the nasopharynx, which interferes with the normal process of respiration, whereas adenoiditis is an inflammatory process occurring in the amygdala itself. The last illness is like a cold.
There is a significant difference in treatment approaches. So, the growth of the tonsil tissue (hypertrophy of the adenoids) without surgery can most likely not be treated. It is necessary to remove excess tissue in the nasopharynx, and this will not work without surgery.Adenoiditis is treated without surgery, and with the help of conservative methods: symptomatic drug therapy, which relieves swelling and relieves inflammation.
Further, we will dwell on the methods of diagnosis and hypertrophy, and adenoiditis (inflammation).
If adenoids are inflamed in a child, what to do? What medications will help to cope with the inflammatory process? Which doctor treats adenoiditis and can remove adenoids if necessary? ENT. This specialist will diagnose the pathological enlargement of the tonsils and prescribe the appropriate therapy. It is impossible to make a decision about drugs independently, since only a physician can correctly distinguish the inflammatory process from an overgrowth (the amygdala of the nasopharynx is impossible to see without a special tool) and select a course of treatment.
ENT diagnoses the disease according to the clinical picture, pharyngoscopy (this is an examination of the nasopharynx of the child), rhinoscopy (examination of the nasal cavity), x-rays. Sometimes endoscopy of the nasopharynx is performed. This is the most informative diagnostic method, and the results can be saved to electronic media.Also, the doctor conducts a differential diagnosis: neoplasm in the nose, septum curvature, hypertrophic rhinitis, and so on.
How to get rid of adenoids? Treatment varies greatly, not only depending on the severity of the pathology, but also on the type of disease. So with the growth of tissue of the first degree, conservative therapy is acceptable, laser treatment. It is recommended that the child in the nose be instilled with a solution of protargol (2%). Showing physiotherapy and restorative therapy. This can be done both in a medical facility and at home. At all stages of therapy, the use of drops, sprays, solutions and other drugs or methods that release the nasal passages from the discharge is recommended. This is the basis of treatment, without which topical medicines will not be effective.
The “Cuckoo” method is widely used. This is an effective method of washing the sinuses. The patient is placed on a couch in the reclining position, then the doctor inserts catheters in the nose. During the isolation procedure, they are mixed with the medicine, exited and absorbed into a special reservoir.The head of the child should be thrown back approximately 45 degrees, it is necessary to maintain immobility. The patient during the procedure should repeat the "cu-ku" to isolate the nasal cavity from the pharynx. For washing, “Dolphin” or “Rinolife” solutions for washing are used.
The opinions of parents about this method of cleansing the nasal sinuses from pus and mucus are positive. After 4-5 procedures, the child begins to breathe freely, headaches and chronic runny nose disappear. But there may be complications from "Cuckoo", caused by such factors as the age of the child and the lack of competence of the doctor. In some cases (if the child becomes unmanageable within the walls of a medical institution), the ENT doctor may allow the procedure to be performed at home.
Locally also used drugs with anti-inflammatory, antibacterial, antihistamine, anti-edema action. It is permissible to use any medications only as prescribed by a doctor, self-medication is completely unacceptable here, as it is possible to miss the time when treatment of adenoids at home is still possible with conservative methods.The proliferation of tissue can be a consequence of the influence of various factors, so that an independent choice of drugs can cause complications.
If the adenoids are inflamed or enlarged, the drops are better.do not use vasoconstrictor, but moisturizing. This is Aqualore or Humer, for example. It is better to give preference to droplets rather than sprays. Antibacterial drugs can only be used as prescribed by the ENT doctor. Often, Sofradex, Bioparox or Isofra are recommended for small patients with adenoids and adenoids. Used and homeopathic remedies that are distinguished by naturalness. This, for example, "Limfomiozot." But homeopathy makes sense to use only in the initial stages. With a complex disease, it will not be effective.
Physiotherapy methods are also widely used in the treatment of hypertrophied adenoids. Electrophoresis, UHF, endonasal ultraviolet irradiation can be performed, visiting special “salt” caves is shown. Of course, all of these additional activities should be combined with medical treatment. One of the modern methods of therapy - laser exposure to overgrowntissue. This reduces local edema, strengthens local immunity, reduces the risk of inflammatory processes.
There are also auxiliary techniques that will help improve the overall immunity, which, of course, will positively affect the health of the child. Such methods of treatment of adenoids include aromatherapy (inhalation of essential oils, which soothe, have a beneficial effect on the respiratory system, relieve stress, cure insomnia, etc.), climatotherapy (temporary climate change), spa treatment, vitamin therapy, respiratory gymnastics, and physical therapy. hardening.
Surgical removal of adenoids is indicated if conservative treatment does not produce a visible effect, and inflammation recurs four times a year or more. If there is no positive dynamics, of course, the doctor will suggest surgery to rule out the development of complications. So, if a child has inflamed or enlarged adenoids, without proper treatment such disorders contribute to frequent tonsillitis, tonsillitis, tracheitis, bronchitis, pharyngitis with all its consequences, hearing impairment due to blockage of the auditory tube, chronic sinusitis due to blockage of the nasal sinuses.
Agree to surgery or not? The operation is performed with anesthesia, but still it is a very big stress for a small child. Considerable excitement brings the situation to parents even if the baby is allergic, but the adenoids continue to grow. The consequences of the operation in this case are unpredictable. That is why many people refuse surgical intervention, and then say that the child has “outgrown” the problem.
Indeed, after nine years, the adenoids begin to decrease in size, and by puberty they almost completely disappear. But this is not the case with all children, and the baby can suffer greatly during this time. If nasal breathing is impaired, less oxygen enters the body, and inflammation is a source of infection, from where it can spread to other organs.
The most common complication of hypertrophy of adenoids and adenoiditis is otitis, which may be accompanied by a violation of hearing sensitivity. This is the main and practically the only “for” operation, since only the minuses further begin:
- if you remove the adenoids, the child will lose natural protection, because it is an important organ that plays a crucial role in shaping the child’s immune defense;
- adenoids can recover, so that after 4-6 months, they are likely to reappear (the earlier the child’s age to perform the operation, the more often there will be relapses);
- removal of the tonsils and surgery may worsen the condition of allergic children, asthmatics, lymphatics;
- the child after removal of the adenoids will not get sick less often, and even vice versa;
- Difficulties in breathing may not be adenoids at all, but, for example, curvature of the septum or prolonged inflammation in the sinuses.
If you still need to do the operation, it is better to carry out it in the autumn-winter period (the time of the absence of allergens) and while taking antihistamines. The operation is contraindicated in children up to two years old, young patients with blood diseases, with exacerbation of various infectious diseases.
Just wait until the child "outgrow" can not. Alleviate nasal breathing will help preventive measures. For example, you need to regularly flush your nose, make inhalations, bury the drops prescribed by the doctor, do breathing exercises. You can use aromatherapy.To do this, you need to buy and put in a children's aroma lamp to arrange sessions with oils of menthol, lavender, thuja, fir or eucalyptus. Especially important when hypertrophied adenoids take vitamins. Be sure to give the child a suitable vitamin and mineral complex in the spring and autumn for two months or one month each season.
Doctor Komarovsky about pathology
The famous pediatrician, who enjoys the confidence of many parents, says that the operation to remove the adenoids is not very difficult, but this does not at all mean that it is safe. Consequences are possible due to anesthesia, bleeding or damage to the palate, but this rarely happens. Will the adenoids reappear after some time? According to Dr. Komarovsky, it does not depend on the qualifications and integrity of the doctor. So, parents who, several months after the operation, again hear the diagnosis “enlarged adenoids”, think that they “got a bad doctor”. But in reality, not a single physician will help if a child lives in adverse conditions (dry air, dust), if there are no physical activities, and the variety and richness of nutrition with nutrients leave much to be desired.